Form Boe-400-Mcu - Application For Consumer Use Tax Account
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2BOE-400-MCU (FRONT) REV. 9 (10-03)
STATE OF CALIFORNIA
APPLICATION FOR CONSUMER USE TAX ACCOUNT
BOARD OF EQUALIZATION
Use additional sheet(s) to include information for more than two individuals
SECTION I: OWNERSHIP INFORMATION
FOR BOARD USE ONLY
1. PLEASE CHECK TYPE OF OWNERSHIP/ENTITY
TAX
IND
OFFICE
NUMBER
Sole Owner
Husband/Wife Co-ownership
SU
Corporation
Limited Liability Partnership (LLP)
[registered
to practice law, accounting or architecture] Provide
Limited Partnership (LP)
BUSINESS CODE
AREA CODE
documents if filed with Secretary of State
Provide documents if filed
with Secretary of State
Limited Liability Company (LLC)
General Partnership
Unincorporated Business Trust
APPLICATION PROCESSED BY
VERIFICATION:
Other (describe)
DL
Other
2. ENTER FULL NAME OF CORPORATION, LP, LLP, LLC, PARTNERSHIP OR UNINCORPORATED BUSINESS TRUST
3. FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
4. CORPORATE, LP, LLP OR LLC, NUMBER FROM CA SECRETARY OF STATE
5. STATE OF INCORPORATION OR ORGANIZATION
OWNER OR PARTNER CHECK ONE
Officer
Manager
Member
Trustee
Beneficiary
Partner
Sole Owner or Co-Owner
6. FULL NAME (first, middle, last)
7. TITLE
8. SOCIAL SECURITY NUMBER (corporate officers excluded, others attach verification)
9. DRIVER LICENSE NUMBER (attach verification)
10. RESIDENCE ADDRESS (street, city, state, zip code)
11. RESIDENCE TELEPHONE NUMBER
(
)
12. NAME, ADDRESS & TELEPHONE NUMBER OF A PERSONAL REFERENCE WHO DOES NOT LIVE WITH YOU
CO-OWNER OR PARTNER CHECK ONE
Officer
Manager
Member
Trustee
Beneficiary
Partner
Co-Owner
13. FULL NAME (first, middle, last)
14. TITLE
15. SOCIAL SECURITY NUMBER (corporate officers excluded, others attach verification)
16. DRIVER LICENSE NUMBER (attach verification)
17. RESIDENCE ADDRESS (street, city, state, zip code)
18. RESIDENCE TELEPHONE NUMBER
(
)
19. NAME, ADDRESS & TELEPHONE NUMBER OF A PERSONAL REFERENCE WHO DOES NOT LIVE WITH YOU
SECTION II: BUSINESS INFORMATION
20. BUSINESS NAME [DBA] (complete if different than entity name)
21. DID YOU INCLUDE A COPY OF YOUR PARTNERSHIP AGREEMENT?
Yes
No
22. BUSINESS ADDRESS (street, city, state, zip code) [do not list P.O. Box or mailing service]
23. BUSINESS TELEPHONE NUMBER
(
)
24. MAILING ADDRESS (street, city, state, zip code) [if different from business address]
25. BUSINESS FAX NUMBER
(
)
26. DATE PURCHASES BEGAN OR WILL BEGIN IN CALIFORNIA (month, day & year)
27. TYPE OF ITEMS PURCHASED OR SERVICE PERFORMED
28. PROJECTED MONTHLY PURCHASES FOR USE IN CALIFORNIA (if unknown, enter an estimate amount)
Total purchases $
Taxable purchases $
29. TYPE OF BUSINESS (check one)
Wholesale
Manufacturing
Service
Construction Contractor
30. OWNERSHIP CHANGES
Are you buying an existing business?
Yes
No If yes, complete items 31 through 35 below.
Are you changing from one type of business organization to another (for example, from a sole owner to a general partnership or from a general
partnership to a limited liability company, etc.)?
Yes
No If yes, complete items 33 and 34 below.
Other:
31. FORMER OWNER’S NAME
32. ACCOUNT NUMBER
33. DO YOU MAKE INTERNET SALES?
34. WEBSITE ADDRESS
Yes
No If yes, answer 34.
35. IF AN ESCROW COMPANY IS REQUESTING A TAX CLEARANCE ON YOUR BEHALF, PLEASE LIST THEIR NAME, ADDRESS, TELEPHONE NUMBER AND THE ESCROW NUMBER
Continued on reverse
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